30 Day Trial

ORTHOWORLD » Other Articles of Interest

Capitalize on These Opportunities in the Emerging Outpatient Surgery Market

By Patrick Vega, Vizient Advisory Solutions

The purpose of this quarterly column is to introduce and discuss key considerations for device companies from the perspective of their customers: hospitals, health systems and physicians. This article provides a description of ambulatory settings and strategies, and suggests ways that device companies can capitalize on the shift from inpatient surgical settings to hospital outpatient departments, ambulatory surgery centers (ASCs) and outpatient sites of care. The collective contributors to this article hypothesize that device companies that better understand the outpatient setting can more effectively adapt their products, services and support to meet customer needs.


The historical model for orthopedic and spine procedures has been inpatient focused, resulting in high revenue and high margins and requiring extensive infrastructure and resources. The emerging model is both inpatient and outpatient. The principal reasons for this shift include:

  • Patient preference for a least restrictive level of care coupled with the convenience of proximate and community-based care
  • First-time or enhanced reimbursement for outpatient-based procedures, which might include reimbursement models like bundled payments or site-neutral reimbursement
  • Improved technology and patient safety; these include pain management techniques, outpatient patient care pathways, minimally invasive surgical techniques, patient selection and highly defined treatment protocols


Orthopedic outpatient procedures are expected to surge in the coming years. The left-hand column in Exhibit 1 describes overall population increases in the U.S. and increased forecasts for orthopedic outpatient volume growth as captured in the population-based forecast bars. Due to the increased movement of higher acuity orthopedic procedures to outpatient settings, such as spine and joint replacement surgeries, Sg2 predicts a 13% increase in outpatient orthopedic surgeries in the next five years, outpacing the increase of population growth alone. In Exhibit 1 Sg2 projects that outpatient hip and knee replacement surgeries will increase over 200% in the next five years with growth projected to be 580% for hip replacement and 752% for knee replacement over the next ten years. 

See the exhibit and read the full article in ORTHOKNOW®.